Instructions for SF-1199A
DIRECT DEPOSIT SIGN UP FORM
Producers use this form to sign up for the direct deposit of benefits from USDA into the account of a payee.
Producers must complete items A through F and provide a signature in Section 1 and all entries in Sections 2 and 3.
Section 1
Fld Name / |
Instruction |
A Name of Payee |
Enter last name, first name and middle initial of payee. Enter complete mailing address of payee. Enter area code and telephone number of payee. |
B Name of Persons Entitles to Payment |
Enter complete name of payee. |
C Claim or Payroll ID Number |
Enter the social security number or employer identification number of payee. |
D Type of Depositor Account |
Mark appropriate type of deposit account. |
E Depositor Account Number |
Enter the account number of the account where payments are to be deposited. |
F Type of Payment |
For USDA purposes, mark box labeled "OTHER" and write "USDA Payments" on the line provided. |
G Allocation of Payment |
Leave blank. No entry is required in this item. |
Signature |
Sign and date under "Payee/Joint Payee Certification" No entry is needed under the Joint Account Holders Certification. |
Section 2
Fld Name / |
Instruction |
Government Agency Name |
Enter the name of the USDA agency issuing payments that are to be deposited directly into the defined account. |
Government Agency Address |
Enter the complete mailing address of USDA agency. |
Section 3
This section can be completed by option A OR option B:
Fld Name / |
Instruction |
Option A |
Take this form to your financial institution and they will complete and sign section 3 for you. You may have them mail this form to the USDA agency in section 2 or you may deliver it in person or mail it yourself to the USDA office, OR |
Option B |
Submit this completed form either by mail or in person with a "VOIDED" check attached. USDA personnel will complete section three with information from the voided check. |